Does Modified Ultra Filtration Affect Clinical Outcome Following Pediatric Cardiac Surgery

Background: Modified ultra filtration (MUF) has become widely used in pediatric cardiac surgery. MUF is capable to remove large amounts of fluid with significant improvement in the post-cardiopulmonary bypass status and laboratory parameters of the patients. There is; however; contradicting reports in the overall clinical outcome benefit following MUF. Methods: Thirty patients weighing less than 15 kg and their median age was 10 months. Undergoing open-heart surgery over a one year period was randomized to either MUF group or conventional ultrafiltration group (CUF). Parameters of investigations included perioperative laboratory findings, hemodynamic status, and duration of hospitalization, and morbidity and mortality rates. The volume of fluid removed with each method was standardized as a percentage of effective fluid balance. Results: There was no significant difference between both groups in age, weight, or duration of cardiopulmonary bypass. MUF patients group received less volume than the CUF group (175 + 72 vs. 196 + 111 ml/kg; p =0.05). There was no difference in the percentage of effective fluid balance that was removed in both groups. The MUF group showed significant higher post-cardiopulmonary bypass hematocrit levels and higher mean arterial blood pressure. Moreover, a significant reduction in chest tube drainage (27 + 16 vs 36 + 11 ml/kg p <0.001) was noted in this group. However, no difference was detected between both groups as regard duration on ventilator, number of days at ICU or at hospital. Conclusion: MUF seems to produce temporary improvement in the immediate post cardiopulmonary bypass period. However; its long term effects is similar CUF.